WordNet

type genus of the family Cancridae (同)genus Cancer
the fourth sign of the zodiac; the sun is in this sign from about June 21 to July 22 (同)Cancer the Crab, Crab
(astrology) a person who is born while the sun is in Cancer (同)Crab
a small zodiacal constellation in the northern hemisphere; between Leo and Gemini
any malignant growth or tumor caused by abnormal and uncontrolled cell division; it may spread to other parts of the body through the lymphatic system or the blood stream (同)malignant neoplastic disease

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〈U〉〈C〉『がん』 / 〈U〉〈C〉害悪 / 《Cancer》(星座の)カニ座

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2012/10/26 14:06:43」(JST)

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File:LymphNodes.jpg

Lymph Nodes in the Neck. Image Provided by NIH^[1]

Hypopharyngeal Cancer is a disease in which malignant cells grow in the hypopharynx (the area where the larynx and esophagus meet).^[2]

It first forms in the outer layer (epithelium) of the hypopharynx (last part of the pharynx), which is split into three areas. Progression of the disease is defined by the spread of cancer into one or more areas and into deeper tissues.^[2]

This type of cancer is rare. Only about 2,500 cases are seen in the US each year.^[3] Because of this, Hypopharyngeal Cancer is difficult to catch in its earliest stages and has one of the highest mortality rates of any head and neck cancer.^[4]

Symptoms

Symptoms of Hypopharyngeal Cancer include:

Swollen lymph nodes in the neck (first sign of a problem in half of all patients) ^[5]
Sore throat in one location that persists after treatment ^[2]
Pain that radiates from the throat to the ears^[2]
Difficult or painful swallowing (often leads to malnutrition and weight loss because of a refusal to eat)^[2]
Voice changes (late stage cancer)^[2]

Causes of hypopharyngeal cancer

Factors that contribute to the development of Hypopharyngeal Cancer include:

Smoking
Chewing tobacco
Heavy alcohol use
Poor diet

Smoking, like lung cancer, can cause Hypopharyngeal Cancer because it contains carcinogens that alter the DNA or RNA in a dividing cell. These alterations may change a normal DNA sequence to an oncogene, a gene that causes cancer after exposure to a carcinogen.

Squamous cells, a type of cell that lines hollow organs like the throat, mouth, lungs, and outer layer of skin, are particularly vulnerable when exposed to cigarette smoke.^[6]

Chewing tobacco can have the same effects as smoking and is also linked to Hypopharyngeal Cancer. The chewing tobacco is placed into the mouth, leaving it exposed to enzymes, like amylase, which partly digests the carcinogenic material. Saliva is swallowed, along with the cancer-promoting material, which passes through the hypopharynx on its way to the esophagus.

Heavy alcohol use is linked to Hypopharyngeal Cancer as well. Alcohol damages the lining of the hypopharynx, increasing the amount of chemicals that are allowed to seep into the underlying membranes. Heavy alcohol use is also associated with nutritional deficiencies. ^[2]

A disease called Plummer-Vinson syndrome, a genetic disorder that causes a long-term iron deficiency, may also lead to Hypopharyngeal Cancer. Other factors like a deficiency in certain vitamins also appear to contribute to this type of cancer.^[2]

Stages and survival rates

Staging cancer is a way of marking the cancer’s progression and is measured on a 0 to 4 (IV) scale. To determine each stage, smaller categories must be defined first: T. N. M. (tumor, lymph nodes, and metastasis). These were developed by the American Joint Committee on Cancer.^[4]

Early stage

Stages of Hypopharyngeal Cancer^[4]
	Tumor (T)	Lymph Nodes (L)	Metastasis (M)
Stage 0	Epithelium Only	None	M0
Stage 1	T1	None	M0
Stage 2	T2	None	M0
Stage 3	T1-T3 Or T3	N1 None	M0 M0
Stage 4 (A)	T1-T3 Or T4	N2 N1-N2	M0 M0
Stage 4 (B)	T4	N1, N2 or N3	M0
Stage 4 (C)	T1-T4	N1-N2	M1

Stage 0

This implies that a tumor was found in the epithelium, the layer of tissue closest to the top, but not in the connective tissue. A patient would not have swollen lymph nodes and the cancer has not metastasized to other tissues or organs. This is almost never diagnosed in the case of Hypopharyngeal Cancer. ^[4]

Stage I (1)

T1: the tumor is less than 2 cm across and is limited to one area in the hypopharynx. There is still no lymph node involvement and no metastasis. ^[4]

Stage I Hypopharyngeal Cancer has a five-year survival rate of 41%, but this type of cancer is rarely caught in Stage I because the first signs and symptoms are often unnoticed or patients remain asymptomatic. ^[4]

Stage II (2)

T2: the tumor has grown to affect more than one area of the hypopharynx and is between 2 and 4 centimeters with no lymph node involvement and no metastasis. ^[4]

Late stage

Stage III (3)

T1 or T2 or T3: the tumor’s growth is between less than 2 cm and more than 4cm and may be affecting the vocal cords. AND N1: cancer has spread to 1 lymph node (same side of the neck as tumor), which has swollen to 3 cm or less. OR T3: the tumor is more than 4cm and is affecting the vocal cords. BUT there is no lymph node involvement. ^[4]

Note: The distinction between the two is made by the oncologist.

Stage II and III have a five-year survival rate of 36%.^[4]

Stage IV (4)

The final stage has three subsets depending on the severity of the cancer.

Stage IVA

T1 or T2 or T3: the tumor is between less than 2 cm or more than 4cm.

AND N2: cancer has spread to 1 or more lymph nodes, less than 6 cm, on 1 or both sides of the neck.

OR

T4: the tumor is affecting different areas outside of the hypopharynx, starting with the throat and moving towards the spine and chest cavity.

AND N1 or N2: cancer is affecting 1 or more lymph nodes that are between less than 3 and less than 6 cm on one or both sides of the throat.

Stage IVB

T4: Tumor is affecting areas outside of the hypopharynx.

N1 or N2 or N3: Lymph nodes are between less than 3 or up to 6 cm on one or both sides of the neck.

Stage IVC (End Stage)

The cancer could be anything from T1 to T4, N1 to N4, but the major difference is the fact that the cancer has metastasized (M1) to other organs away from the hypopharynx.

Stage IV Hypopharyneal Cancer only has a 10% five-year survival. ^[4]

Most cases of Hypopharyneal Cancer are found in the End Stage because the cancer is in close proximity to several large lymphatic vessels easily spreading to other regions of the body.^[7]

Tests to diagnose hypopharyngeal cancer

There are several ways to diagnose Hypopharyngeal Cancer.

Physical Examination:

The doctor checks for swollen lymph nodes and may look down the patient’s throat with a long handled mirror. ^[2]

Endoscopy, Esophagoscopy, or Bronchoscopy:

Inserted into the nose or mouth of the patient, this a thin, lighted tube that allows the doctor to see farther down the throat, into the esophagus or into the trachea.^[2]

Biopsy:

This is a small tissue sample that can be acquired during an endosopy, esophagoscopy, or bronchoscopy. The tissue is analyzed for the presences of cancer cells.^[2]

CT scan or MRI:

These tests will give doctors a detailed picture of any abnormalities in the body. For a CT scan, the patient often swallows a dye that coats the throat and provides a better image. An MRI is a better tool if the patient is pregnant because the test uses no radiation.^[2]

Treatments

Treatment of hypopharyngeal cancer depends on the prognosis (chance of recovery), age, stage, and general health of the patient. Because hypopharyngeal cancer is often advanced at the time of diagnosis, treatment also depends on the overall goal. The goal may simply be to keep the patient talking, eating, and breathing normally.^[7]

Treatment usually begins with surgery and then a course of radiation for cancer that has progressed passed Stage I. For cancer that is advanced, which is typical of hypopharyngeal cancer, neoadjuvant chemotherapy may be used. This is performed by administering chemotherapy before surgery. Neoadjuvant chemotherapy in conjunction with radiation and surgery has yielded the best results in patients with Stage III and Stage IV cancers.^[7]

References

^ MedlinePlus: Head and Neck Cancer
^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j ^k ^l National Cancer Institute. General Information About Hypopharyngeal Cancer
^ WebMd. Hypopharyngeal Cancer Treatment
^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j American Cancer Society. Detailed Guide: Laryngeal and Hypopharyngeal Cancer How Are Laryngeal and Hypopharyngeal Cancers Staged?
^ E Medicine. Hypopharyngeal Cancer: History.
^ Medicine.com. Definition of Squamous Cells.
^ ^a ^b ^c National Cancer Institute. Hypopharyngeal Cancer Treatment (PDQ)

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 早期（ステージIおよびII）の頭頸部癌の治療：下咽頭 treatment of early stage i and ii head and neck cancer the hypopharynx
2. 局所進行性（ステージⅢおよびⅣ）頭頚部癌の治療：咽頭および下咽頭 treatment of locoregionally advanced stage iii and iv head and neck cancer the larynx and hypopharynx
3. 頭頚部癌の診断および病期分類の概要 overview of the diagnosis and staging of head and neck cancer
4. 局所進行性（ステージⅢおよびⅣ）頭頚部癌の治療：中咽頭 treatment of locoregionally advanced stage iii and iv head and neck cancer the oropharynx
5. 頭頸部癌患者の言語および嚥下リハビリテーション speech and swallowing rehabilitation of the patient with head and neck cancer

English Journal

Indications for superselective intra-arterial cisplatin infusion and concomitant radiotherapy in cases of hypopharyngeal cancer.

Furusawa J1, Homma A2, Onimaru R3, Sakashita T1, Yoshida D3, Hatakeyama H1, Mizumachi T1, Kano S1, Tsuchiya K3, Yasuda K3, Shirato H3, Fukuda S1.
Auris, nasus, larynx.Auris Nasus Larynx.2015 Dec;42(6):443-8. doi: 10.1016/j.anl.2015.04.003. Epub 2015 Apr 28.
OBJECTIVE: We retrospectively assessed the indications for superselective intra-arterial infusion of cisplatin with concomitant radiotherapy (RADPLAT) in patients with hypopharyngeal cancer (HPC).METHODS: Between April 2000 and March 2013, 41 previously untreated patients received superselective int
PMID 25933585

Acid reflux and head and neck cancer risk: A nationwide registry over 13 years.

Kuo CL1, Chen YT2, Shiao AS3, Lien CF4, Wang SJ5.
Auris, nasus, larynx.Auris Nasus Larynx.2015 Oct;42(5):401-5. doi: 10.1016/j.anl.2015.03.008. Epub 2015 May 18.
OBJECTIVE: Gastro-esophageal reflux disease (GERD) is a highly prevalent disorder; however, important questions remain regarding the link between GERD and extra-esophageal cancers. This nationwide cohort study investigated the risk of developing head and neck cancers (HNCs) among patients with GERD.
PMID 25998850

Hypopharyngeal reconstruction: a comparison of three alternatives.

Elfeky AE1, Nasr WF, Khazbak A, Abdelrahman MS, Allam ZA, Gareer WY, Elsebaey H.
European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery.Eur Arch Otorhinolaryngol.2015 Oct;272(10):3045-50. doi: 10.1007/s00405-014-3306-x. Epub 2014 Sep 27.
This study aimed to evaluate the operative outcomes of using gastric pull-up (GPU), pectoralis major myocutaneous flap (PMMF), and jejunal free flap (JFF) to reconstruct the hypopharynx after resection of hypopharyngeal and cervical esophageal carcinoma. Retrospective clinical study. Otolaryngology
PMID 25261105

Japanese Journal

Staged operation for synchronous quintuple cancer in the oral cavity, hypopharynx, and esophagus

Yoshida Rintaro,Morita Masaru,Kumashiro Ryuichi [他]
Esophagus : official journal of the Japan Esophageal Society 9(4), 228-233, 2012-12-00
NAID 40019542110

表在中下咽頭癌の内視鏡的切除を安全に施行するコツ (特集食道・中下咽頭表在癌の診断と治療)

飯塚敏郎,菊池大輔,布袋屋修 [他]
消化器内科 55(4), 459-465, 2012-10-00
NAID 40019486140

高用量シスプラチンを用いた化学放射線同時併用療法における栄養状態の変化に関する検討 : 特に放射線単独療法との違いについて

中原晋,吉野邦俊,藤井隆 [他]
日本耳鼻咽喉科学会会報 115(10), 902-909, 2012-10-00
NAID 40019470865

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★リンクテーブル★

リンク元	「下咽頭癌」「下咽頭がん」「hypopharyngeal neoplasm」「hypopharyngeal carcinoma」
関連記事	「cancer」「hypopharyngeal」